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Phase 2a > Mock SAQs 2 > Flashcards

Mock SAQs 2 Flashcards

1
Q

A 51-year old man present is referred by his GP to an endocrinologist for suspected acromegaly.

What is the most common cause of acromegaly?

A

GH secreting pituitary tumour

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2
Q

A 51-year old man present is referred by his GP to an endocrinologist for suspected acromegaly.

List three symptoms of acromegaly?

A
  1. Excessive sweating
  2. Decreased libido
  3. Headaches
  4. Muscular weakness
  5. Thickening skin
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3
Q

A 51-year old man present is referred by his GP to an endocrinologist for suspected acromegaly.

What is the diagnostic test for acromegaly?

A

Glucose tolerance test

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4
Q

A 51-year old man present is referred by his GP to an endocrinologist for suspected acromegaly.

The diagnosis of acromegaly is confirmed. What are the two groups of pharmacological therapies that he could be prescribed?

A

GH antagonists
Somatostatin analogues
Dopamine agonists

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5
Q

A 51-year old man present is referred by his GP to an endocrinologist for suspected acromegaly.

Name two associated comorbidities of acromegaly?

A 
Hypertension
Arthritis 
Obstructive sleep apnoea
Heart diease 
Impaired glucose tolerance 
Diabetes
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6
Q

A 48-year old woman present to A&E with a sharp, severe chest pain that is by relieved sitting forwards. The doctor suspects pericarditis.

What are two differential diagnoses for pericarditis?

A 
Acute coronary sydrome 
Aortic dissection 
Gastric ulcer 
Oesophagitis 
Pancreatitis 
Pneumonia 
Pleuritis
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7
Q

A 48-year old woman present to A&E with a sharp, severe chest pain that is by relieved sitting forwards. The doctor suspects pericarditis.

Name an investigations that should be carried out in this patient and it’s results?

A

ECG

Saddle shaped ST elevation

PR depression

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8
Q

A 48-year old woman present to A&E with a sharp, severe chest pain that is by relieved sitting forwards. The doctor suspects pericarditis.

What drug can be given to reduce the chance of recurrence of pericarditis?

A

Colchichine

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9
Q

A 48-year old woman present to A&E with a sharp, severe chest pain that is by relieved sitting forwards. The doctor suspects pericarditis.

Three complications of pericarditis?

A

Pericardial effusion
Cardiac tamponade
Constrictive pericarditis

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10
Q

A 20-year old woman has been recently diagnosed with iron deficiency anaemia.

What type of anaemia is iron deficient anaemia?

A

Microcytic

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11
Q

A 20-year old woman has been recently diagnosed with iron deficiency anaemia.

What are two causes of iron deficient anaemia?

A

Poor iron intake
Malabsorption
Increased demands i.e growth and pregnancy

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12
Q

A 20-year old woman has been recently diagnosed with iron deficiency anaemia.

What are three symptoms of anaemia?

A 
Fatigue 
Lethargy 
Dyspnoea 
Palpitation 
Intermittent claudication
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13
Q

A 20-year old woman has been recently diagnosed with iron deficiency anaemia.

How is iron transported in the blood and how is it stored?

A

Transported bound to transferrin and stored as ferritin

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14
Q

A 40-year old man is suffering with dyspepsia and epigastric tenderness during and just after eating. His GP suspects a peptic ulcer.

What are 3 causes of peptic ulcers?

A

NSAIDs
Smoking
Mucosal ischaemia
Increased gastric secretion

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15
Q

A 40-year old man is suffering with dyspepsia and epigastric tenderness during and just after eating. His GP suspects a peptic ulcer.

From his presentation, where do you expect is peptic ulcer to be and why?

A

Stomach, his epigastric tenderness is during eating/after, intestinal would be a when hungry, duodenal at night

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16
Q

A 40-year old man is suffering with dyspepsia and epigastric tenderness during and just after eating. His GP suspects a peptic ulcer.

What drug group can be used to reduce gastric acid secretion?

A

Proton pump inhibitors

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17
Q

A 40-year old man is suffering with dyspepsia and epigastric tenderness during and just after eating. His GP suspects a peptic ulcer.

What is a complication of peptic ulceration?

A

Bleeding

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18
Q

A 22-year old man has gradual onset back and buttock pain that is relieved somewhat on exercise. He is referred to a rheumatologist and ankylosing spondylitis is diagnosed.

What group of inflammatory joint disorders does this fall under?

A

Spondyloarthropathy

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19
Q

A 22-year old man has gradual onset back and buttock pain that is relieved somewhat on exercise. He is referred to a rheumatologist and ankylosing spondylitis is diagnosed.

What genetic association to these conditions share?

A

HLA-B27 association

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20
Q

A 22-year old man has gradual onset back and buttock pain that is relieved somewhat on exercise. He is referred to a rheumatologist and ankylosing spondylitis is diagnosed.

Other than the features listed, name two other features of this condition?

A 
Psoriasis 
Enthesitis 
Dactylitis 
Crohns 
UC 
Eye involvement
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21
Q

A 22-year old man has gradual onset back and buttock pain that is relieved somewhat on exercise. He is referred to a rheumatologist and ankylosing spondylitis is diagnosed.

What is the first sign on x ray of this condition?

A

Sacroilitis

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22
Q

A 22-year old man has gradual onset back and buttock pain that is relieved somewhat on exercise. He is referred to a rheumatologist and ankylosing spondylitis is diagnosed.

Name three means of management for this condition?E

A

Excercise
Phyisotherapy
NSAIDS
TNF-alpha blockers

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23
Q

A woman presents to A+E with acute kidney injury.

What are two different diagnostic criteria for this condition?

A

Rise in creatinine 1.5x the baseline

<0.5ml/kg/hr for >6 hours §

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24
Q

A woman presents to A+E with acute kidney injury.

What are two risk factors for acute kidney injury?

A 
Old age
CKD 
Cardiac failure 
PVD 
Sepsis 
Poor fluid intake/loss
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25
Q

A woman presents to A+E with acute kidney injury.

Name 2 pre renal and 2 renal causes of acute kidney injury?

A

Pre: hypotension, hypovoleimia, renal artery stenosis

Renal: Acute tubular necrosis, glomerulonephritis, drugs, vasculitis, autoimmune

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26
Q

A woman presents to A+E with acute kidney injury.

Why might hyperkalaemia occur in AKI?

A

It causes reduced renal excretion of potassium

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27
Q

A 70 year old man has had a recent diagnosis of parkinsons diesease.

What are two histological findings that you can see in a person with PD?

A

Lewy bodies

Degeneration of dopaminergic neurons

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28
Q

A 70 year old man has had a recent diagnosis of parkinsons diesease.

What are two characteristic signs in the gait of a person with PD?

A

Shuffling

Reduced arm swing

Slow to get going

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29
Q

A 70 year old man has had a recent diagnosis of parkinsons diesease.

What are the dopaminergic changes seen in PD?

A

Reduced dopamine in the substantia nigra

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30
Q

A 70 year old man has had a recent diagnosis of parkinsons diesease.

List 2 pharmacological strategies to manage PD?

A

L dopa

Dopamine agonists

COMT/MAO-V inhibitors

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31
Q

A 60-year old lady present to her GP with a mark on her nose that she is concerned could be cancer. The GP examines it and describes it as a pearly papule with rolled edges.

What type of cancer is it most likely to be?

A

Basal cell carcinoma

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32
Q

A 60-year old lady present to her GP with a mark on her nose that she is concerned could be cancer. The GP examines it and describes it as a pearly papule with rolled edges.

What are three risk factors for skin cancer?

A

UV light
Family history
Pale skin

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33
Q

A 60-year old lady present to her GP with a mark on her nose that she is concerned could be cancer. The GP examines it and describes it as a pearly papule with rolled edges.

What is the first line treatment for any skin cancer?

A

Surgical excision

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34
Q

A 60-year old lady present to her GP with a mark on her nose that she is concerned could be cancer. The GP examines it and describes it as a pearly papule with rolled edges.

Malignant melanoma is more aggressive than skin cancer, name four features of a melanoma lesion that would point towards its diagnosis?

A 
Pigmented 
Asymmetrical 
Border irregularity 
Colour irregularity 
Changes over time 
Diameter >6mm
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35
Q

A 19-year old boy present to his GP with a continuous low mood and sadness and he is concerned he may have depression. The GP agrees and prescribes him some medication that may help, he is booked another consultation for 4-week time.

What are three risk factors for depression?

A 
History 
Grief 
Conflict 
Abuse 
Life events 
Illness 
Medication
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36
Q

A 19-year old boy present to his GP with a continuous low mood and sadness and he is concerned he may have depression. The GP agrees and prescribes him some medication that may help, he is booked another consultation for 4-week time.

How does depression manifest physically - give three examples?

A 
Moving slowly 
Changes in appetite 
Constipation 
Lack of energy 
Loss of libido 
Changes to menstrual cycle 
Disturbed sleep
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37
Q

A 19-year old boy present to his GP with a continuous low mood and sadness and he is concerned he may have depression. The GP agrees and prescribes him some medication that may help, he is booked another consultation for 4-week time.

Name two types of medication that the GP could of prescribed him?

A

Selective serotonin reuptake inhibitors

Tricyclic antidepressants

Monoamine oxidase inhibitors

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38
Q

A 19-year old boy present to his GP with a continuous low mood and sadness and he is concerned he may have depression. The GP agrees and prescribes him some medication that may help, he is booked another consultation for 4-week time.

What should the GP warn the patient about when prescribing anti-depressants?

A

You may feel worse in the short term, any suicidal thoughts and he should come back

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39
Q

A 19-year old boy present to his GP with a continuous low mood and sadness and he is concerned he may have depression. The GP agrees and prescribes him some medication that may help, he is booked another consultation for 4-week time.

3 non pharmalogical therapies for depression?

A

Mindfullness
Depression
CBT
Excercise

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40
Q

10-year old child presents to her GP practice unwell with a one-day history of fever, drowsiness, photophobia and neck stiffness. The doctor suspects meningitis.

What is the most common organism to cause meningitis?

A

Strepococcus pneumoniae

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41
Q

10-year old child presents to her GP practice unwell with a one-day history of fever, drowsiness, photophobia and neck stiffness. The doctor suspects meningitis.

What could would streptococcus pneumoniae stain with gram stain?

A

Pink

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42
Q

10-year old child presents to her GP practice unwell with a one-day history of fever, drowsiness, photophobia and neck stiffness. The doctor suspects meningitis.

The GP calls for an ambulance for the child to go to hospital, what else should he do?

A

Give IM benzylpenicillin

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43
Q

10-year old child presents to her GP practice unwell with a one-day history of fever, drowsiness, photophobia and neck stiffness. The doctor suspects meningitis.

At the hospital a lumbar puncture is carried out, it confirms that the organism is a bacteria, what features from analysis may indicate this?

A 
Cloudy 
Neutrophils 
Gram film visible 
High protein
Low glucose
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44
Q

10-year old child presents to her GP practice unwell with a one-day history of fever, drowsiness, photophobia and neck stiffness. The doctor suspects meningitis.

In what case would a lumbar puncture be contraindicated in meningitis?

A

If septicaemia is indicated i.e. rash

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45
Q

80-year old woman in referred to a urology clinic due to stress incontinence.

What is stress incontinence?

A

Involuntary emission of urine when pressure in the abdomen increases suddenly

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46
Q

80-year old woman in referred to a urology clinic due to stress incontinence.

What anatomical differences make stress incontinence more likely in women?

A

Only one sphincter

Shorter urethra

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47
Q

80-year old woman in referred to a urology clinic due to stress incontinence.

What are three other types of incontinence?

A

Urgency, mixed, continuous and overflow

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48
Q

80-year old woman in referred to a urology clinic due to stress incontinence.

First line of management for stress incontinence?

A

Pelvic floor exercises

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49
Q

A 54-year-old man goes to see his GP regularly for his annual diabetic
review. The doctor takes his blood pressure which is shown to be
145/93mmHg

List three other risk factors for hypertension?

A 
Family history 
Lack of physical activity 
Obesity 
High salt intake 
Smoking 
High alcohol intake
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50
Q

A 54-year-old man goes to see his GP regularly for his annual diabetic
review. The doctor takes his blood pressure which is shown to be
145/93mmHg

What blood pressure should be aimed for someone with diabetes mellitus?

A

<130/80mmHg

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51
Q

A 54-year-old man goes to see his GP regularly for his annual diabetic
review. The doctor takes his blood pressure which is shown to be
145/93mmHg

List two complications of hypertension?

A 
Retinopathy 
Heart failure 
Ischaemic heart disease 
Renal failure 
Headache 
Nausea 
Impotence
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52
Q

A 54-year-old man goes to see his GP regularly for his annual diabetic
review. The doctor takes his blood pressure which is shown to be
145/93mmHg

What type of medication should be given to treat HTN given an example?

A

ACEi

Rampril

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53
Q

A 54-year-old man goes to see his GP regularly for his annual diabetic
review. The doctor takes his blood pressure which is shown to be
145/93mmHg

Name a test that could be done to assess potential organ damage from hypertension, name the test and result?

A

Echo or ECG - LV hypertrophy or past MI

Urine analysis- shows proteinuria to check kidney function

Fundoscopy - asses hypertensive retinopathy

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54
Q

A 25-year-old female comes into A&E unable to breath, in and out of
consciousness. Her family member says she was stung by a bee but
weren’t aware she was allergic to anything. However she does have
eczema and her mother has asthma. The doctors suspect she has
undergone anaphylaxis.

List 2 signs that the doctors would look for to determine if its indeed anaphylaxis

A 
Lowered bP 
Dyspnoea due to bronchoconstriction 
Rash 
Swelling 
Vomiting
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55
Q

A 25-year-old female comes into A&E unable to breath, in and out of
consciousness. Her family member says she was stung by a bee but
weren’t aware she was allergic to anything. However she does have
eczema and her mother has asthma. The doctors suspect she has
undergone anaphylaxis.

What type of hypersensitivity is anaphylaxis?

A

Type 1

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56
Q

A 25-year-old female comes into A&E unable to breath, in and out of
consciousness. Her family member says she was stung by a bee but
weren’t aware she was allergic to anything. However she does have
eczema and her mother has asthma. The doctors suspect she has
undergone anaphylaxis.

What immunoglobulin is involved in allergic reactions?

A

IgE

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57
Q

A 25-year-old female comes into A&E unable to breath, in and out of
consciousness. Her family member says she was stung by a bee but
weren’t aware she was allergic to anything. However she does have
eczema and her mother has asthma. The doctors suspect she has
undergone anaphylaxis.

Briefly expain the mechanism of re exposure in anaphylaxis?

A

Allergen binds to IgE

Receptor cross linking causes a cascade

Mast cell degranulation of histamine

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58
Q

A 25-year-old female comes into A&E unable to breath, in and out of
consciousness. Her family member says she was stung by a bee but
weren’t aware she was allergic to anything. However she does have
eczema and her mother has asthma. The doctors suspect she has
undergone anaphylaxis.

What dosage route and drug would be given?

A

300mg

IM

Adrenaline

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59
Q

50-year-old man comes into his GP. The patient complaints of Lower
urinary tract symptoms. The doctor performs a digital rectal exam and
finds his prostate to be smooth and enlarged; he suspects benign prostatic
hyperplasia.

What is the pathophysiology of BPH?

A

Benign nodular or diffuse proliferation
Of muculofibrous and glandular layers of prostate
Inner /transitional zone enlarges

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60
Q

50-year-old man comes into his GP. The patient complaints of Lower
urinary tract symptoms. The doctor performs a digital rectal exam and
finds his prostate to be smooth and enlarged; he suspects benign prostatic
hyperplasia.

Name on storage and one voiding LUTS?

A

Storage: Frequency, urgency, nocturia

Voiding: Stream poor, Hesitancy, Incomplete emptying, Post micturition dribble

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61
Q

50-year-old man comes into his GP. The patient complaints of Lower
urinary tract symptoms. The doctor performs a digital rectal exam and
finds his prostate to be smooth and enlarged; he suspects benign prostatic
hyperplasia.

List three differentials of LUTS?

A

UTI
Porstatis
Prostate cancer MS
Diuretic medication

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62
Q

50-year-old man comes into his GP. The patient complaints of Lower
urinary tract symptoms. The doctor performs a digital rectal exam and
finds his prostate to be smooth and enlarged; he suspects benign prostatic
hyperplasia.

Name an investigation that could be done to differentiate from malignancy?

A

Prostate specific antigen - shouldn’t be too high however can be raised if BPH large

Transrectal ultrasound and biopsy - histology of biopsy

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63
Q

A 4-year-old girl has been brought in, to see the GP, by her mother. On
examination there are itchy, erythematous and scaly patches on her skin.
These are locates on her cheeks and in the flexure of her elbows. Her skin
in general is seen to be quite dry. The mother explains how they
themselves have asthma and that their child has been recently diagnosed
with asthma too.

What is the most likely diagnosis of this child’s complaint|?

A

Atopic eczema

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64
Q

A 4-year-old girl has been brought in, to see the GP, by her mother. On
examination there are itchy, erythematous and scaly patches on her skin.
These are locates on her cheeks and in the flexure of her elbows. Her skin
in general is seen to be quite dry. The mother explains how they
themselves have asthma and that their child has been recently diagnosed
with asthma too.

|n acute lesions, Staph auerus common, name a test an result to confirm this?

A

Gram - positive

Coagulase - positive

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65
Q

A 4-year-old girl has been brought in, to see the GP, by her mother. On
examination there are itchy, erythematous and scaly patches on her skin.
These are locates on her cheeks and in the flexure of her elbows. Her skin
in general is seen to be quite dry. The mother explains how they
themselves have asthma and that their child has been recently diagnosed
with asthma too.

Describe the cause of eczema?

A

Loss of natural moisturising factors causes cracks in the skin

Abnormal lipid bilayer provides inaqudate permeability barrier

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66
Q

A 4-year-old girl has been brought in, to see the GP, by her mother. On
examination there are itchy, erythematous and scaly patches on her skin.
These are locates on her cheeks and in the flexure of her elbows. Her skin
in general is seen to be quite dry. The mother explains how they
themselves have asthma and that their child has been recently diagnosed
with asthma too.

How does emollient therapy help eczema?

A

Emmollients - artificial restoration of barrier in skin by trapping moisture in the skin

Artificial permeability is formed about stratum corneum

Prevents water loss between corenocytes

67
Q

A 4-year-old girl has been brought in, to see the GP, by her mother. On
examination there are itchy, erythematous and scaly patches on her skin.
These are locates on her cheeks and in the flexure of her elbows. Her skin
in general is seen to be quite dry. The mother explains how they
themselves have asthma and that their child has been recently diagnosed
with asthma too.

Name a mild treatment for atopic eczema?

A

Corticosterioids

Hydrocortisone

68
Q

A 14 year old female has come into A&E with a fever, severe abdominal
pain and vomiting. On examination the pain is seen to be at McBurney’s
point, the doctors suspect appendicitis. This is confirmed after a CT.

Give the definition of appendicitis?

A

Inflammation of the appendix

69
Q

A 14 year old female has come into A&E with a fever, severe abdominal
pain and vomiting. On examination the pain is seen to be at McBurney’s
point, the doctors suspect appendicitis. This is confirmed after a CT.

What two results may be shown in a blood test that can help confirm the diagnosis of appendicitis?

A

Raised white cell count

Raised CRP

70
Q

A 14 year old female has come into A&E with a fever, severe abdominal
pain and vomiting. On examination the pain is seen to be at McBurney’s
point, the doctors suspect appendicitis. This is confirmed after a CT.

OTher than fever, abdo pain and vomitting, list three other signs of appendicitis?

A 
Anorexia 
Nausea 
Guarding 
Constipation 
Tachycardia 
Rebound tenderness 
Pain on movement
71
Q

A 14 year old female has come into A&E with a fever, severe abdominal
pain and vomiting. On examination the pain is seen to be at McBurney’s
point, the doctors suspect appendicitis. This is confirmed after a CT.

List three differential diagnoses of appendicitis?

A 
Ectopic pregnancy
UTI 
Cystitis 
Cholecystitis 
Diverticulitis 
Perforated ucler
72
Q

A 14 year old female has come into A&E with a fever, severe abdominal
pain and vomiting. On examination the pain is seen to be at McBurney’s
point, the doctors suspect appendicitis. This is confirmed after a CT.

Treatment for appendicitis?

A

Appendicectomy

73
Q

A father brings in his 5-year-old son into A&E. The boy has been irritable,
getting progressively drowsy and shown signs of photophobia. On
examination the doctor notices a non-blanching petechial and purpuric
skin rash.

What is the triad of presentation in bacterial meningitis?

A

Headache
Neck stiffness
Fever

74
Q

A father brings in his 5-year-old son into A&E. The boy has been irritable,
getting progressively drowsy and shown signs of photophobia. On
examination the doctor notices a non-blanching petechial and purpuric
skin rash.

List two common causes of bacterial meningitis in children?

A

Nessieria meningits
Streptococcus pneumoniae
Haemophilius influenza

75
Q

A father brings in his 5-year-old son into A&E. The boy has been irritable,
getting progressively drowsy and shown signs of photophobia. On
examination the doctor notices a non-blanching petechial and purpuric
skin rash.

List 2 results you would expect to see in the CSF findings of someone with bacterial meningitis?

A

CSF is turbid colour

Neutrophils/poylmorphs

Raised protein

Low glucose

76
Q

A father brings in his 5-year-old son into A&E. The boy has been irritable,
getting progressively drowsy and shown signs of photophobia. On
examination the doctor notices a non-blanching petechial and purpuric
skin rash.

How to differentiate from a sub arachnoid haemorrhage?

A

SAH headache is far more sudden and severe

77
Q

A father brings in his 5-year-old son into A&E. The boy has been irritable,
getting progressively drowsy and shown signs of photophobia. On
examination the doctor notices a non-blanching petechial and purpuric
skin rash.

How would you manage someone with a suspected meningococcal septicaemia?

A

Immediate IV cefotaxime

Do not perform lumbar puncture due to risk of raised ICP

Confirm diagnosis with blood cultures instead

78
Q

A 64-year-old woman is taken to A&E after a fall in her home. After an X-
ray it is clear she has a fracture of her proximal femur. Due to her age and having undergone menopause the doctors complete a DEXA scan, which provided a score of -2.3

What would a T score of -2.3 give?

A

Osteopenia

79
Q

A 64-year-old woman is taken to A&E after a fall in her home. After an X-
ray it is clear she has a fracture of her proximal femur. Due to her age and having undergone menopause the doctors complete a DEXA scan, which provided a score of -2.3

What is the minimum for osteoporsis?

A

-2.5

80
Q

A 64-year-old woman is taken to A&E after a fall in her home. After an X-
ray it is clear she has a fracture of her proximal femur. Due to her age and having undergone menopause the doctors complete a DEXA scan, which provided a score of -2.3

What does DEXA stand for?

A

Duel energy xray absorptiometry

81
Q

A 64-year-old woman is taken to A&E after a fall in her home. After an X-
ray it is clear she has a fracture of her proximal femur. Due to her age and having undergone menopause the doctors complete a DEXA scan, which provided a score of -2.3

What is the first line treatment for osteoporosis?

A

Bisphosphonates

E.g. alendronate

82
Q

A 64-year-old woman is taken to A&E after a fall in her home. After an X-
ray it is clear she has a fracture of her proximal femur. Due to her age and having undergone menopause the doctors complete a DEXA scan, which provided a score of -2.3

HRT is also a good choice of treatment for this women. How does menopause cause osteoporosis?

A

Post menopause means lower estrogen levels

increased number of osteoclasts / premature arrest of osteoblastic activity

High bone turnover

83
Q

A 64-year-old woman is taken to A&E after a fall in her home. After an X-
ray it is clear she has a fracture of her proximal femur. Due to her age and having undergone menopause the doctors complete a DEXA scan, which provided a score of -2.3

What test could differentiate between osteoporosis from osteomalacia?

A

Blood test

Ca2+ / phosphate is normal in osteoporosis

Low Ca+ / phosphate in osteomalacia

84
Q

A 6 year old boy is taken into A&E. He is dehydrated, drowsy and
vomiting. He has Kussmaul breathing and his breath has a distinct pear
drop smell. The doctors suspect he has ketoacidosis.

What is the triad of ketoacidosis?

A

Hyperglycaemia

Ketonaemia

Acidaemia

85
Q

A 6 year old boy is taken into A&E. He is dehydrated, drowsy and
vomiting. He has Kussmaul breathing and his breath has a distinct pear
drop smell. The doctors suspect he has ketoacidosis.

What blood test could be done to diagnose ketoacidosis?

A

Blood pH - acidaemia <7.3

Blood glucose >11mmol/L

Ketones >3mmol?l

86
Q

A 6 year old boy is taken into A&E. He is dehydrated, drowsy and
vomiting. He has Kussmaul breathing and his breath has a distinct pear
drop smell. The doctors suspect he has ketoacidosis.

Describe how ketoacidosis occurs?

A

In absence of insulin

Unrestrained increase in hepatic gluconeogenesis / peripheral uptake by tissues is decreased

Ketones produced as bodies require glucose in cells / ketone bodies accumulate

87
Q

A 6 year old boy is taken into A&E. He is dehydrated, drowsy and
vomiting. He has Kussmaul breathing and his breath has a distinct pear
drop smell. The doctors suspect he has ketoacidosis.

What would the HbA1c levels of someone with suspected diabetes be?

A

> 46mmol

88
Q

A 19-year-old male has come back from a year abroad, mainly around
Africa. He has gone to see his GP due to feeling feverish, nauseous and
having diarrhoea. He told the GP he thinks he has the flu but the GP
believes there is a chance it is malaria.

What microorganism causes complicated malaria?

A

Plasmodium falciparum

89
Q

A 19-year-old male has come back from a year abroad, mainly around
Africa. He has gone to see his GP due to feeling feverish, nauseous and
having diarrhoea. He told the GP he thinks he has the flu but the GP
believes there is a chance it is malaria.

Name a test that could confirm this diagnoses what would it detect?

A

Thick and thin film
Thick = presence of malaria
Thin - type of plasmodium

Rapid diagnostic test - detects plasmodium antigens in the blood

90
Q

A 19-year-old male has come back from a year abroad, mainly around
Africa. He has gone to see his GP due to feeling feverish, nauseous and
having diarrhoea. He told the GP he thinks he has the flu but the GP
believes there is a chance it is malaria.

List 2 symptoms of complicated malaria?

A

Shock
Cerebral malaria
Kidney failure
Acute respiratory distress syndrome

91
Q

A 19-year-old male has come back from a year abroad, mainly around
Africa. He has gone to see his GP due to feeling feverish, nauseous and
having diarrhoea. He told the GP he thinks he has the flu but the GP
believes there is a chance it is malaria.

List the three stages of malaria infection?

A

Exo-erythrocytic stage

Endo-erythrocytic stage

Hypnozoite stage

92
Q

A 38-year-old woman comes into A&E presenting with delirium tremens
and Wernicke’s encephalopathy. She has also been vomiting and is
tachycardic. On examination, the liver feels enlarged.

What is a likely cause of the patients enlarged liver?

A

Alcoholic liver disease
Alcoholic fatty liver
Alcoholic hepatitis
Alcoholic cirrhosis

93
Q

A 38-year-old woman comes into A&E presenting with delirium tremens
and Wernicke’s encephalopathy. She has also been vomiting and is
tachycardic. On examination, the liver feels enlarged.

Name a blood test you could do to confirm diagnosis? and result of the test?

A

Liver function test: AST:ALT >2 / raised GGT

FBC - raised WCC / macrocytic anaemia

Coagulation - increased PTT

94
Q

A 38-year-old woman comes into A&E presenting with delirium tremens
and Wernicke’s encephalopathy. She has also been vomiting and is
tachycardic. On examination, the liver feels enlarged.

How would you treat delirium tremors?

A

Chlordiazepoxide

Lorazepam

95
Q

A 38-year-old woman comes into A&E presenting with delirium tremens
and Wernicke’s encephalopathy. She has also been vomiting and is
tachycardic. On examination, the liver feels enlarged.

Name two causes of Wernickes encephalopathy?

A

Chronic alcoholism
Eating disorders
Malnutrition
Prolonged vomitting

96
Q

A 38-year-old woman comes into A&E presenting with delirium tremens
and Wernicke’s encephalopathy. She has also been vomiting and is
tachycardic. On examination, the liver feels enlarged.

What is the triad of Wernicke’s encephalopathy?

A

Confusion
Ataxia
Opthalmoplegia

97
Q

A 56-year-old female is at her GP for her annual diabetes check. She has
type 2 diabetes mellitus, which isn’t very well managed and has remained
at a BMI of 32 and her BP was measured at 143/90. She has complained
of feeling breathless, urinating often, especially at night and her legs
feeling swollen. On examination the doctor can see clearly oedema in her
legs and hear crackles in her lungs when breathing. A&E blood test is
performed and the doctor believes she has chronic kidney disease.

What result of the U&E could show it was CKD?

A

Creatinine
Glucose
Low calcium
High phosphate

98
Q

A 56-year-old female is at her GP for her annual diabetes check. She has
type 2 diabetes mellitus, which isn’t very well managed and has remained
at a BMI of 32 and her BP was measured at 143/90. She has complained
of feeling breathless, urinating often, especially at night and her legs
feeling swollen. On examination the doctor can see clearly oedema in her
legs and hear crackles in her lungs when breathing. A&E blood test is
performed and the doctor believes she has chronic kidney disease.

What other test could be done to help confirm this diagnosis?

A

Ultrasound kidneys, ureter = abnormal anatomical/ obstruction

CT kidney / bladder = detect stones, retroperitoneal fibrosis / urinary obstruction

Renal biopsy - nephrotic syndrome

Urine dipstick - high albumin / glucose

99
Q

A 56-year-old female is at her GP for her annual diabetes check. She has
type 2 diabetes mellitus, which isn’t very well managed and has remained
at a BMI of 32 and her BP was measured at 143/90. She has complained
of feeling breathless, urinating often, especially at night and her legs
feeling swollen. On examination the doctor can see clearly oedema in her
legs and hear crackles in her lungs when breathing. A&E blood test is
performed and the doctor believes she has chronic kidney disease.

Her GFR is measure to be 46 giving her a G3a CKD, what GFR is needed for kidney failure?

A

<15

100
Q

A 56-year-old female is at her GP for her annual diabetes check. She has
type 2 diabetes mellitus, which isn’t very well managed and has remained
at a BMI of 32 and her BP was measured at 143/90. She has complained
of feeling breathless, urinating often, especially at night and her legs
feeling swollen. On examination the doctor can see clearly oedema in her
legs and hear crackles in her lungs when breathing. A&E blood test is
performed and the doctor believes she has chronic kidney disease.

Diabetse is a systemic cause of CKD, name three others?

A

Amyloidosis
Drugs/toxins
Heart failure
Organ rejection

101
Q

A 56-year-old female is at her GP for her annual diabetes check. She has
type 2 diabetes mellitus, which isn’t very well managed and has remained
at a BMI of 32 and her BP was measured at 143/90. She has complained
of feeling breathless, urinating often, especially at night and her legs
feeling swollen. On examination the doctor can see clearly oedema in her
legs and hear crackles in her lungs when breathing. A&E blood test is
performed and the doctor believes she has chronic kidney disease.

Describe the pathogenesis of CKD?

A

Scarred nephrons fail

Burden of filtration falls to remaining health nephrons / hyperfiltration / glomerular hypertrophy occurs

Increased glomerular capillary pressure and strain cause damage to remaining nephrons

102
Q

A 19-year-old Northern European man presents to the hospital with nausea and
vomiting. On further examination, the doctor discovers the man has been having an
increasing need to urinate, unexplained weight loss and feels frequently dehydrated.
The doctor suspects diabetes mellitus

The doctor undergoes a random plasma glucose test - what is the range of values to to indicate diabetes mellitus?

A

> 11.1 mmol/L

103
Q

A 19-year-old Northern European man presents to the hospital with nausea and
vomiting. On further examination, the doctor discovers the man has been having an
increasing need to urinate, unexplained weight loss and feels frequently dehydrated.
The doctor suspects diabetes mellitus

Give two examples of other investigations that could be done to confirm the diagnosis?

A

Fasting plasma glucose >7mmol/L

HbA1c >6.5% from normal

104
Q

A 19-year-old Northern European man presents to the hospital with nausea and
vomiting. On further examination, the doctor discovers the man has been having an
increasing need to urinate, unexplained weight loss and feels frequently dehydrated.
The doctor suspects diabetes mellitus

Give 2 macrovascular and 2 microvascular complications?

A

macro = htn,MI, diabetic foot

micro = nephropathy, retinopathy, perirpheral neuropathy

105
Q

A 19-year-old Northern European man presents to the hospital with nausea and
vomiting. On further examination, the doctor discovers the man has been having an
increasing need to urinate, unexplained weight loss and feels frequently dehydrated.
The doctor suspects diabetes mellitus

GLUT2 receptors found on the surface of insulin releasing cells usually have a low affinity for glucose, why?

A

Glucose is only detected at higher concentrations and thus insulin is only released when blood glucose is high

106
Q

A 19-year-old Northern European man presents to the hospital with nausea and
vomiting. On further examination, the doctor discovers the man has been having an
increasing need to urinate, unexplained weight loss and feels frequently dehydrated.
The doctor suspects diabetes mellitus

Give 2 side effects of insulin therapy?

A

Weight gain
Hypoglycaemia
Localised lipoatrophy
Hypokalaemia

107
Q

A 60 year old man reports chest pain that woke him from his sleep. He thinks the
pain lasted around 20 minutes and felt sweaty during the pain. He did not want to
bother anyone so he rested and the pain eased. He says it was painful and thus
wants to be checked. He is currently not in pain, but feels tired.

Give three differentials for stable angina chest pain?

A 
Pericarditis 
PE 
Chest infection 
Dissection of aorta 
GORD
108
Q

A 60 year old man reports chest pain that woke him from his sleep. He thinks the
pain lasted around 20 minutes and felt sweaty during the pain. He did not want to
bother anyone so he rested and the pain eased. He says it was painful and thus
wants to be checked. He is currently not in pain, but feels tired.

ECG of stable angina?

A

Usually normal

May show ST depression

109
Q

A 60 year old man reports chest pain that woke him from his sleep. He thinks the
pain lasted around 20 minutes and felt sweaty during the pain. He did not want to
bother anyone so he rested and the pain eased. He says it was painful and thus
wants to be checked. He is currently not in pain, but feels tired.

Give examples of tests other than ECG that can assess for stable angina?

A

Coronary angiography
Blood tests
Functional imaging

110
Q

A 60 year old man reports chest pain that woke him from his sleep. He thinks the
pain lasted around 20 minutes and felt sweaty during the pain. He did not want to
bother anyone so he rested and the pain eased. He says it was painful and thus
wants to be checked. He is currently not in pain, but feels tired.

Give a conservative, medical and surgical option for treatment of stable angina?

A

Conservative = smoking cessation, weight loss, exercise

Medical = GTN, aspirin

Surgical = CABG, PTCA

111
Q

20 year old male is suspected to have a Hodgkin’s Lymphoma.

Give 2 examples of risk factors of Hodgkins lymphoma?

A

An affected sibling
Epstein barr virus infection
SLE

112
Q

20 year old male is suspected to have a Hodgkin’s Lymphoma.

Give one symptom and one sign of HL?

A

Symptom = weigh loss, lethargy

Sign = Cachexia, anaemia

113
Q

20 year old male is suspected to have a Hodgkin’s Lymphoma.

What staging system can be used to determine treatment and prognosis?

A

Ann arbor system

114
Q

20 year old male is suspected to have a Hodgkin’s Lymphoma.

What is the most common subtype of hodgkins lymphoma?

A

Nodular sclerosing

115
Q

20 year old male is suspected to have a Hodgkin’s Lymphoma.

Which subtype of Hodgkins lymphoma has the worst prognosis?

A

Lymphocyte depleted

116
Q

20 year old male is suspected to have a Hodgkin’s Lymphoma.

Patient is treated by radiotherapy and AVDB regimen, name the drugs?

A

Adriamycin Bleomycin Vinblastine Dacarbazine

117
Q

40 year old female presents with abdominal pain that radiates to the back that she has had for some time. The pain is recurrent and made worse by eating or drinking heavily, but relieved by sitting forward. She does not smoke and drinks around 20 units per week.
Doctor suspects pancreatitis.

Give three examples of what can cause chronic pancreatitis?

A 
Alcohol 
Smoking 
Autoimmunity 
Pancreatic duct obstruction
Cystic fibrosis
118
Q

40 year old female presents with abdominal pain that radiates to the back that she has had for some time. The pain is recurrent and made worse by eating or drinking heavily, but relieved by sitting forward. She does not smoke and drinks around 20 units per week.
Doctor suspects pancreatitis.

What tests can be done to confirm chronic pancreatitis?

A

Ultrasound or CT scan of the abdomen

Magnetic Resonance Cholangiopancreatography (MRCP)

Abdominal x ray shows speckled calcificaiton

119
Q

40 year old female presents with abdominal pain that radiates to the back that she has had for some time. The pain is recurrent and made worse by eating or drinking heavily, but relieved by sitting forward. She does not smoke and drinks around 20 units per week.
Doctor suspects pancreatitis.

State a conservative and medical treatment option for this patient?

A

Conservative: alcohol cessation, low fat diet

Medical: analgesia e.g. tramadol, pancreatic enzyme replacement therapy, insulin if DM

120
Q

40 year old female presents with abdominal pain that radiates to the back that she has had for some time. The pain is recurrent and made worse by eating or drinking heavily, but relieved by sitting forward. She does not smoke and drinks around 20 units per week.
Doctor suspects pancreatitis.

State 2 potential complications of chronic pancreatitis?

A 
Pseudocyst 
Diabetes meillutus 
Billary obstruction 
Local arterial aneurysm 
Gastric varicies
121
Q

21 year old male presents with increasing pain and prolonged morning stiffness in the lower back and buttocks. He smokes a pack/day and finds his symptoms improve with exercise. He presents to the doctor with a question mark posture and has a bamboo spine. The doctor suspects him to have ankylosing spondylitis.

Name three other types of seronegative spondyloaropathies?

A

Psoriatic arthritis
Enteropathic arthritis
Reactive arthritis

122
Q

21 year old male presents with increasing pain and prolonged morning stiffness in the lower back and buttocks. He smokes a pack/day and finds his symptoms improve with exercise. He presents to the doctor with a question mark posture and has a bamboo spine. The doctor suspects him to have ankylosing spondylitis.

What parts of the skeletal system are inflamed in ankylosing spondylitis?

A

Spine
Ribcage
Sacroiliac joints

123
Q

21 year old male presents with increasing pain and prolonged morning stiffness in the lower back and buttocks. He smokes a pack/day and finds his symptoms improve with exercise. He presents to the doctor with a question mark posture and has a bamboo spine. The doctor suspects him to have ankylosing spondylitis.

What antigen is strongly associated with all seronegative spondyloaropathies?

A

HLA B27

124
Q

21 year old male presents with increasing pain and prolonged morning stiffness in the lower back and buttocks. He smokes a pack/day and finds his symptoms improve with exercise. He presents to the doctor with a question mark posture and has a bamboo spine. The doctor suspects him to have ankylosing spondylitis.

State 1 radiological investigation that can be used to test for ankylosing spondylitis?

A

MRI scan, X ray of the spine

125
Q

21 year old male presents with increasing pain and prolonged morning stiffness in the lower back and buttocks. He smokes a pack/day and finds his symptoms improve with exercise. He presents to the doctor with a question mark posture and has a bamboo spine. The doctor suspects him to have ankylosing spondylitis.

Vertebral syndesmophytes are characterisic of ankylosing spondylitis, what are verebrel syndesmophytes?

A

Bony proliferations due to enthesitis between ligaments and vertebrae

126
Q

21 year old male presents with increasing pain and prolonged morning stiffness in the lower back and buttocks. He smokes a pack/day and finds his symptoms improve with exercise. He presents to the doctor with a question mark posture and has a bamboo spine. The doctor suspects him to have ankylosing spondylitis.

State two medical treatment options for this patient?

A

TNF alpha inhibitors
NSAIDS
DMARD
Consider bisphosphonates

127
Q

21 year old male presents with increasing pain and prolonged morning stiffness in the lower back and buttocks. He smokes a pack/day and finds his symptoms improve with exercise. He presents to the doctor with a question mark posture and has a bamboo spine. The doctor suspects him to have ankylosing spondylitis.

Give an exmample of something that would indicate a worse prognosis for this patient?

A

ESR >30
Onset >16 years
Early hip involvement
Poor response to nsaids

128
Q

A 30 year old female is suspected to have a acute kidney injury (AKI).

Give an example of a pre renal, renal and post renal cause of AKI?

A

Pre renal = hypovolaemia(haemorrhage/burns), shock (sepsis)

Renal = glomerular disease(vasculitis, glomerulonephritis, SLE) tubulointestinal disease (acute tubular necrosis)

Post renal = obstruction of the ureter (stones, tumour), obstruction of the bladder neck

129
Q

A 30 year old female is suspected to have a acute kidney injury (AKI).

What is the most common cause of AKI?

A

Sepsis

130
Q

A 30 year old female is suspected to have a acute kidney injury (AKI).

Urinanalysis investigation is used to test for an AKI. Name 2 substances that you would look for in urine to suggest the presence of AKI?

A 
Blood 
Protein 
Glucose 
Leucocytes
Nitrates 
Bence jones protein
131
Q

A 30 year old female is suspected to have a acute kidney injury (AKI).

How would creatinine change if there was an AKI?

A

> 26 micromol/L in 48 hours

Rise in creatinine 1.5x baseline within 7 days

132
Q

A 30 year old female is suspected to have a acute kidney injury (AKI).

What urine output would be diagnostic of AKI?

A

<0.5ml/kg/hr for >6 consecutuve hours

133
Q

A 30 year old female is suspected to have a acute kidney injury (AKI).

Hyperkalaemia is a medical emergency and a potential complication of AKI, what two drugs comprise the first line medical management of this emergency?

A

Insulin and dextrose

134
Q

A 60 year old female is suspected to have motor neurone disease, she is found to have a pattern of UMN and LMN signs

What 2 clinical patterns of MND could this be?

A

Amyotrophic lateral sclerosis

Progressive bulbar palsy

135
Q

A 60 year old female is suspected to have motor neurone disease, she is found to have a pattern of UMN and LMN signs

Define weakness?

A

Impaired ability to move a body part in response to will

136
Q

A 60 year old female is suspected to have motor neurone disease, she is found to have a pattern of UMN and LMN signs

Give an example of a UMN sign and an LMN sign other than weakness?

A

UMN= spasticity, brisk reflexes, upturned plantars

LMN = muscle wasting, fasciculations of the tongue/abdomen

137
Q

A 60 year old female is suspected to have motor neurone disease, she is found to have a pattern of UMN and LMN signs

How can MND be distinguished from multiple sclerosis and polyneuropathies?

A

No sensory loss of sphincter disturbance in MND

138
Q

A 60 year old female is suspected to have motor neurone disease, she is found to have a pattern of UMN and LMN signs

How can MND be distinguished from myasthenia gravis?

A

MND never affects eye movements

139
Q

A 60 year old female is suspected to have motor neurone disease, she is found to have a pattern of UMN and LMN signs

Name an investigation that can help diagnose MND other than clinical diagnosis?

A

Brain / spinal cord MRI

Lumbar puncture

Nerve conduction studies

140
Q

A 60 year old female is suspected to have motor neurone disease, she is found to have a pattern of UMN and LMN signs

What is the only medication shown to improve the survival of patients suffering from MND and hoe does it work?

A

Riluzole

Inhibitor of glutamate release and NMDA receptor antagonist

141
Q

A 25 year old male presents with a fever, rash and headache. Doctor suspects a HIV infection.

Give two differential diagnoses of a fever?

A

Pneumonia
Meningitis
Encephalitis
TB

142
Q

A 25 year old male presents with a fever, rash and headache. Doctor suspects a HIV infection.

Name 2 genes of the HIV genome and their function?

A

Pol - encordes reverse transcription

Eny - encodes the envelope proteins

Nef - increases infectivity

Tat - enhances the production of host transcription

Gag - encodes structural proteins

143
Q

A 25 year old male presents with a fever, rash and headache. Doctor suspects a HIV infection.

Give an example of an opportunistic infection from HIV?

A

Toxoplasma gondii
Pneumocystitis jiroveci
Candidias
Cryptosporidium

144
Q

A 25 year old male presents with a fever, rash and headache. Doctor suspects a HIV infection.

What cells to HIV antigens bind to and enter?

A

CD4+ lymphocyte

145
Q

A 25 year old male presents with a fever, rash and headache. Doctor suspects a HIV infection.

Part of the HIV replication processes involves the reverse transcriptase enzyme, name a drug that inhibits it?

A

Zidovudine (NRTI)

146
Q

A 70 year old male is suspected to have colorectal cancer. He is smoking 10 cigarettes a day, has IBD and a possible history of CRC.

Define carcinoma?

A

Malignant tumour of epithelial cells

147
Q

A 70 year old male is suspected to have colorectal cancer. He is smoking 10 cigarettes a day, has IBD and a possible history of CRC.

What is the most common type of carcinoma found in CRC?

A

Adenocarcinoma

148
Q

A 70 year old male is suspected to have colorectal cancer. He is smoking 10 cigarettes a day, has IBD and a possible history of CRC.

State 2 possible symptoms or signs of CRC?

A

Abdo pain
Unintentional weight loss
Altered bowl habit
Faecal occult blood

149
Q

A 70 year old male is suspected to have colorectal cancer. He is smoking 10 cigarettes a day, has IBD and a possible history of CRC.

What is the current bowl cancer screening program?

A

Faecal occult blood test in men and women aged 60-69

150
Q

A 70 year old male is suspected to have colorectal cancer. He is smoking 10 cigarettes a day, has IBD and a possible history of CRC.

What two method can be used to stage CRC?

A

Duke’s staging system

TMN system

151
Q

A 70 year old male is suspected to have colorectal cancer. He is smoking 10 cigarettes a day, has IBD and a possible history of CRC.

Patient is diagnose d with CRC, give an example of a conservative, medical and surgical treatment option?

A

Conservative - referral to MacMillan nurses, patient education, smoking cessation

Medical, radiotherapy, chemoptherapy

Surgical - surgical resection of bowel

152
Q

40 year old female is feeling tearful, hopeless, anxious, and a continuous low mood for the last 4 weeks. She also states its affecting her work and feels shes taking part in increasingly less social activities. Doctor feels this patient is suffering from depression.

Give 2 examples of physical symptoms that could be associated with depression?

A

Unexplained aches or pains
Disturbed sleep
Changes to menstrual cycle
Disturbed sleep

153
Q

40 year old female is feeling tearful, hopeless, anxious, and a continuous low mood for the last 4 weeks. She also states its affecting her work and feels shes taking part in increasingly less social activities. Doctor feels this patient is suffering from depression.

What is the only antidepressant that can be described to under 18 year olds?

A

SSRI - fluoxetine

154
Q

40 year old female is feeling tearful, hopeless, anxious, and a continuous low mood for the last 4 weeks. She also states its affecting her work and feels shes taking part in increasingly less social activities. Doctor feels this patient is suffering from depression.

Minimum length of time you should experience depression symptoms for before seeking help?

A

Every day for 2 weeks

155
Q

40 year old female is feeling tearful, hopeless, anxious, and a continuous low mood for the last 4 weeks. She also states its affecting her work and feels shes taking part in increasingly less social activities. Doctor feels this patient is suffering from depression.

Give an example of withdrawl symptom of antidepressant medication?

A

Upset stomach
Flu like symptoms
Anxiety
Dizziness

156
Q

25 year old male works in a bakery, he suffers from hayfever and a family history of atopy. He presents with wheeze, cough that mainly comes on a t night, sputum and sometimes difficulty breathing. He is diagnosed with asthma.

What is atopy?

A

Individuals who rapidly develop IgE against common environmental antigens

157
Q

25 year old male works in a bakery, he suffers from hayfever and a family history of atopy. He presents with wheeze, cough that mainly comes on a t night, sputum and sometimes difficulty breathing. He is diagnosed with asthma.

State 2 differential diagnoses of asthma?

A 
Pulmonary oedema 
COPD 
Large airway obstruciton 
Pneumothorax 
PE 
SVC obstruction
158
Q

25 year old male works in a bakery, he suffers from hayfever and a family history of atopy. He presents with wheeze, cough that mainly comes on a t night, sputum and sometimes difficulty breathing. He is diagnosed with asthma.

State two signs of asthma?

A

Tachypnoea
Audible wheeze
Hyper inflated chest
Hyper resonant percussion note

159
Q

25 year old male works in a bakery, he suffers from hayfever and a family history of atopy. He presents with wheeze, cough that mainly comes on a t night, sputum and sometimes difficulty breathing. He is diagnosed with asthma.

What is the initial investigation of suspected asthma in an adult after clinical investigation?

A

Spirometry or peak expiratory flow

160
Q

25 year old male works in a bakery, he suffers from hayfever and a family history of atopy. He presents with wheeze, cough that mainly comes on a t night, sputum and sometimes difficulty breathing. He is diagnosed with asthma.

What range of values for FEV1/FVC ratio mean the patient has airways obstruction?

A

FEV1/FVC below 0.7

161
Q

25 year old male works in a bakery, he suffers from hayfever and a family history of atopy. He presents with wheeze, cough that mainly comes on a t night, sputum and sometimes difficulty breathing. He is diagnosed with asthma.

Patient find his symptoms decrease on a weekend when his isnt working.

How could you confirm suspicions of his job being a trigger for his asthma?

A

Ask the patient to measure their peak flow intervals at home and at work at the same time of day to confirm this

162
Q

25 year old male works in a bakery, he suffers from hayfever and a family history of atopy. He presents with wheeze, cough that mainly comes on a t night, sputum and sometimes difficulty breathing. He is diagnosed with asthma.

Patient find his symptoms decrease on a weekend when his isnt working.

State some precipitants of asthma symptoms other than flour?

A 
Cold air 
Exercise 
Allergens 
Infection 
Smoking 
Pollution 
NSAIDS 
beta blokers
163
Q

25 year old male works in a bakery, he suffers from hayfever and a family history of atopy. He presents with wheeze, cough that mainly comes on a t night, sputum and sometimes difficulty breathing. He is diagnosed with asthma.

Patient find his symptoms decrease on a weekend when his isnt working.

Which. is the first line treatment for chronic asthma?

A

Salbutamol or a short acting beta 2 antagonist

164
Q

25 year old male works in a bakery, he suffers from hayfever and a family history of atopy. He presents with wheeze, cough that mainly comes on a t night, sputum and sometimes difficulty breathing. He is diagnosed with asthma.

Patient find his symptoms decrease on a weekend when his isnt working.

In the case of an acute severe asthma attack, state 1 way you could asses the severity of the attack?

A 
Peak expiratory flow 
Ability to speak 
Respiratory rate 
Pulse rate 
O2 stats

Phase 2a (13 decks)

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